Category: Justice

How can Jubilee help us respond to COVID-19?

We are in the midst of one of the worst global pandemics of a century.  What does it have to do with healthcare and Christian mission?  There are many lessons we are learning.   But one clear message is that this pandemic is much more than the disease of COVID-19.  While preparations, PPE, and medical care are vital, we are also learning how to respond to many non-medical issues.  As a mission agency we are considering a multitude of threats which COVID-19 has revealed — from loss of livelihood, disruption of education, family breakdown, and loss of social cohesion.  Loss of freedom and bondage are especially evident among those with fewer resources.

A snapshot of this disruption is captured by quotes from local pastors during trainings over the last few months done by the Maternal and Newborn Community Health project of Kijabe Hospital, Kenya.

  • “The church is full of fear… We have noticed even the titles like Pastors and Reverend are of no value when we cannot place food on the table; we are forced to do any available job.  COVID-19 has reduced us to nothing.”
  • “Most marriages are separating, the wives are going upcountry or the village and husband is remaining in the slum.”
  • “.. we are anticipating a major social crisis in the next year in this region, especially teenage mothers.”
  • “..experiencing suicidal cases in this slum, something that was not common.”
  • “.. more domestic violence..”
  • “..parents are exposing their children to early sex, especially when they lack food, children are forced to prostitution to earn from long distance truck drivers..”
  • “..family assaults.”   
  • “..child abuse.”

On the positive side:

  • “We are revisiting how to prudently manage finance and resources we have.”
  • “We are sharing the little we have with the needy.”

Our healthcare workers are already working hard to care for those  ill with COVID-19, and in many cases don’t have time, energy or expertise to address these other foundational issues.  And what can be done about family dysfunction, lack of employment, anxiety and loss of hope?  What can be done by beyond our medical and public health responses?

The answer is that much can be done!  The good news of the gospel, centered on the death and resurrection of our Lord Jesus, impels us to enter into these sufferings and address all of life, not only the brokeness of our relationship to God but also the brokeness of our fellow human beings.

A powerful reminder of God’s care for mankind in both dimensions is the Jewish feast of Jubilee.  The Jubilee was designed by God to restore land to families that had sold land due to poverty and economic hardship; it was a mechanism that protected extended families from a downward spiral of poverty.  Leviticus 25: 10-12 reads

10 Consecrate the fiftieth year and proclaim liberty throughout the land to all its inhabitants. It shall be a jubilee for you; each of you is to return to your family property and to your own clan. 11 The fiftieth year shall be a jubilee for you; do not sow and do not reap what grows of itself or harvest the untended vines. 12 For it is a jubilee and is to be holy for you; eat only what is taken directly from the fields.

Jubilee was one of the many provision God built into His law to counteract the effects of sin and greed, and protect His people — keeping family and livelihood together. It was meant to be an overflow of His grace; the very word “Jubilee” is also translated “liberty” or “freedom.” God’s goodness provided practical means of overcoming economic bondage and slavery.

Christopher Wright points to the Jubilee as “God’s Model of Restoration,” in The Mission of God. “What God required of Israel in God’s land reflects what in principle he desires for humanity on God’s earth — namely, broadly equitable distribution of the resources of the earth, especially land, and a curb on the tendency to accumulation with its inevitable oppression and alienation.” Jesus himself carries this Jubilee theme as he declares His own mission statement (based on Isaiah 61) in Luke 4:18-19, saying

18 “The Spirit of the Lord is on me,    because he has anointed me
    to proclaim good news to the poor.
He has sent me to proclaim freedom for the prisoners
    and recovery of sight for the blind,
to set the oppressed free,
19     to proclaim the year of the Lord’s favor.”[a]

Thus our mission to proclaim good news to the poor (by our words) is designed to accompany efforts to set the oppressed free by attending to issues of oppression, debt, and economic slavery. And since this kind of freedom is not possible by our own efforts, it should cause us even more to marvel at the grace of the Lord Jesus Christ, grateful for His cross — both in saving us from sin as well as restoring brokenhearted and oppressed people.

All this must humble us as we think of these African pastors and their dilemma. The Lord hears their cry both for the spiritual darkness which surrounds them as well as the social and systemic effects of sin — in the midst of the physical challenges of the COVID-19 pandemic. We join them in making the good news of Jesus known in their communities, confident that He has put His people there in order to speak His words and show His deeds of love to hurting communities. “Mission” is our call to follow Jesus as He redeems and restores broken communities.

Community based approaches to primary health care

When I studied international and community health at Johns Hopkins in 1977, primary health care was a new emphasis. Our dean, Dr. Carl Taylor led a department full of passion about reducing illness and promoting health through primary care. But the amount of data about this approach was limited. Like many others, I found that the dream was charming, but not so easily implemented when I went to Ethiopia.

So I was encouraged to hear that now there are over 700 studies in the medical literature which support community based primary health care. Dr. Henry Perry and others at Johns Hopkins have published their findings in the Journal of Global Health here.

The evidence supports CBPHC as an important component of a comprehensively-designed maternal and child health program, not just for the direct effects on maternal and child morbidity and mortality, but because of its contribution to appropriate usage of hospital and clinic facilities. In other words, we need a balance of curative, preventative and promotive.  The evidence is clear.

Here are some aspects of CBPHC:

  • Engagement of women’s groups
  • Innovation like puppet shows
  • Paid and unpaid local workers and volunteers
  • Strengthening the staff of peripheral health centers
  • Using both medical professionals and non-professionals in complementary ways
  • Regular home visits
  • Community based case management
  • Mobile teams

Dr. Perry points out that belief in curative medicine is very powerful; sometimes we are mesmerized by technology and curative care. While they have a very important place, we also know that a large percentage of illness can be mitigated, prevented or treated by non-medical means. We want to embrace good clinical care, of course, but balance this with sustained and intentional efforts to impact communities in broader, more ‘non-technical’ ways. CBPHC may not be technologically sophisticated, yet it can be powerful.

In terms of social justice, Perry points out the CBPHC can have a ‘pro-equity’ effect, avoiding the potential barriers to health care that institutions by themselves can have.

As we make disciples in our healthcare missions, let us remember to raise up both medical professionals and non-professionals, staff who work in institutions as well as those who work in communities.  With needs pressing in around us, we must keep hospitals functioning well yet not consume all of our resources on them — but balance clinical care (tertiary and secondary care) with community based primary health care. We need not only doctors, but social workers, health promoters, and grandmothers who are willing to make the sacrifice to love and invest in communities in order to bring healing to the brokenhearted and hope to those suffering around us.

If we are outsiders to a culture (expats or missionaries) we shouldn’t be naive about the difficulty of such an approach. It often touches on deeply held values, dreams, and cultural approaches which are distorted by our own rebellion from God and the ways of His kingdom. But as we love individuals and learn to serve side-by-side in humility with local people, we can discover how great is our Lord Jesus and enable many to find fullness of life in Him.

A new era in Roman healthcare

We take for granted that compassion is a natural response to the suffering of those who are ill. But compassion was not well-developed as a virtue in Roman culture.  Rome had not developed a culture of compassion; “mercy was discouraged, as it only helped those too weak to contribute to society.” Family members may come to one’s aid, and the wealthy could afford physicians, but “the common folk were often left to rely on folk healers and sellers of herbs, amulets and quack remedies.” *

“If a father decided that the family couldn’t afford another child, that child would be abandoned to the steps of a temple or in the public square. Female infants were exposed much more often than males.” These attitudes and practices are still with us today.  In India and China the practice of aborting female offspring is distressingly common.  In many parts of the world the handicapped are treated with disdain or neglect.

“The classic world possessed no religious or philosophical basis for the concept of the divine dignity of human persons, and without such support, the right to live was granted or withheld by family or society almost at a whim.”

What made the difference between attitudes then and now?  At least in many parts of the world today, human rights and dignity are considered absolutely fundamental (and they are!). Where then did these more ‘progressive’ beliefs come from?  The new ‘era’ in Roman healthcare came from the least likely place: from a new, small and persecuted culture which penetrated the classic Roman world: the culture of the Christians.

Despite a series of ten devastating persecutions, beginning with Nero in AD 64, Christians “carried on an active ministry of philanthropy which included the care of the sick. Far from the stereotype of shriveled ascetics who hated the body, early Christians valued the body and the medical arts necessary to heal it as good gifts from God.”

“James defines “religion that is pure and undefiled before God” in part as caring for ‘orphans and widows’ (James 1:27) — biblical shorthand for all those without protectors and in need. Christian theology thus birthed a personal and corporate charity which surpassing any previously known. Church leadership encouraged all Christians to visit the sick and help the poor, and each congregation also established an organized ministry of mercy.”

How different this is from our practices today!  How often we are concerned about ourselves without hearing the Lord’s commands to love God with all our heart and our neighbors as ourselves.

“A devastating epidemic began in 250 AD and spread across northern Africa to the Western Empire.  It lasted 15 to 20 years, and at one point in Rome 5,000 people died in one day. Beyond offering supplications to the gods for relief, public officials did nothing to prevent the spread of the disease, treat the sick, or bury the dead. This is not surprising, since the pagans believed that nothing effective could be done in a time of plague other than appeasing the gods.”  However in places like Carthage, north Africa, where the plague swept in with force, the Bishop Cyprian  “encouraged Christians to donate funds and volunteer their service for relief efforts, making no distinction between believers and pagans.”  They continued these organized emergency relief efforts for five years.

“The ministry of medical care in early Christianity began as a church-based diaconal, not a professional, ministry.  It was provided by unskilled, ordinary people with no medical training. Yet the church created in the first two centuries of its existence the only organization in the Roman world that systematically cared for its destitute sick.”

This is not a secret we want to keep from believers around the world today.  From Syria to Thailand, believers are caring for those who are marginalized and ill.  But sometimes I fear we forget our history, and we forget God’s command to love our neighbor.  Medical missions are a wonderful calling and ministry. But as we go about it we must not ‘overly professionalize’ ministry to those who are sick and brokenhearted. Unskilled believers ushered in a new era of healthcare in the Roman empire.  We have the opportunity to do the same among multiplied countries around the world, demonstrating goodness and grace of God, and the dignity of men and women created in His image.  This can be done only as professionals work together with non-medical professionals to care for the needs around them, especially those who are least able to help themselves.

Despite the cost, let’s help usher in a new era of healthcare around the world.

*Quotations are from “Christian History, Healthcare and Hospitals in the mission of the church,” Issue 101, pages 6-12

Not the way it’s supposed to be

“The veins of sin interlace with most of the rest of what’s wrong with our lives — through birth disorders, disease, accident and nuisance. Thousands of Third World children die daily from largely preventable diseases: out of laziness or complacency, certain grownups fail to prevent them. Thousands of First World children are born drug addicts: their mothers have hooked them in the womb. Some people with sexually transmitted diseases knowingly put their partners at terrible risk. It happens every day. Many accidents are, in retrospect, both accidental and predictable: somebody who needed to concentrate on his job in order to protect others (a pilot for example, or a lifeguard, or a ship’s captain) got drunk instead, or careless, or wholely preoccupied. Often, a number of such factors combine in some lethal and intricate way to bring havoc to human well-being.”

Cornelius Plantinga helps us look at sin and how it affects, and corrupts, the beauty and design of God’s creation. Most of us do not hear as much in our churches about sin as our grandparents did. It is at the root of much pain and suffering in this world. “Self-deception about our sin is a narcotic.” He wants to “renew our memory of the integrity of creation and sharpen our eye for the beauty of grace.”

In looking at root causes (and possible prevention) of diseases in Ethiopia in the 1980s I was struck that the causes were not just ignorance but sin. Nowdays in the West we classify intolerance as sin, but there is so much more lurking in the background which we tend to ignore: promiscuity, cheating, corruption, power-grabbing, pride, lying, dishonoring of others.  Ultimately this comes from the dishonoring of God who created and designed us.

I said to a colleague at the time, “My community program would work just fine if it weren’t for sin!”

That is largely true, and shows us our need for the forgiveness of sin found only at the cross of Christ. Community health is a good work, but community change is most effective when founded on love.

“Sin distorts our character, a central feature of our very humanity. Sin corrupts powerful human capacities — thought, emotion, speech, and act — so that they become centers of attack on others or of defection or neglect…. Sin, moreover, lies at the root of such big miseries as loneliness, restlessness, estrangement, shame and meaninglessness… In fact sin typically both causes and results from misery.”

“Sin is disruption of created harmony and then resistance to divine restoration of that harmony.”

“At the center of the Christian Bible, four Gospels describe the pains God has taken to defeat sin and its wages… Christians have always measured sin, in part, by the suffering needed to atone for it.  The ripping and writhing of a body on a cross, the bizarre metaphysical maneuver of using death to defeat death, the urgency of the summons to human beings to ally themselves with the events of Christ and with the person of those events, and then make that person the center of of their lives — those things tell us that the main human trouble is desperately difficult to fix, even for God, and that sin is the longest-running of human emergencies.”

So as we serve others with compassion, let us not ignore the longest-running of human emergencies.  Things are not the way they are supposed to be. Let’s make a full diagnosis of our human condition and receive God’s full remedy.

 

 

 

"Every Good Endeavor"

“Christians’ disengagement from popular culture usually carries over into dualism at work. “Dualism” is a term used to describe a separating wall between the sacred and the secular. it is a direct result of a thin view of sin, common grace, and God’s providential purposes.

“Dualism leads some to think that if their work is to please Christ, it must be done overtly in his name. They feel they have to write and perform art that explicitly mentions Jesus, or teach religious subjects in a Christian school; or that they must work in an organization in which all people are professing Christians. Or they must let everyone know that they lead Bible studies in the office in the morning before work hours. This kind of dualism comes both from a failure to see the panoramic scope of common grace and the subtle depths of human sin.  People with this view cannot see that work done by non-Christians always contains some degree of God’s common grace as well as the distortions of sin. And they cannot see that work done by Christians, even if it overtly names the name of Jesus, is also significantly distorted by sin.

“The opposite dualistic approach, however, is even more prevalent — and based on our experience, even more difficult to dismantle. In this approach, Christians think of themselves as Christians only within church activity. Their Christian life is what they do on Sundays and weeknights, when they engage in spiritual activities The rest of the week they have no ability to think circumspectly about the underlying values they are consuming and living out. In their life and work “out in the world,” they uncritically accept and reenact all of their culture’s underlying values and idolatries of self, surface appearances, technique, personal freedom, materialism, and other features of expressive individualism. While the first form of dualism fails to grasp the importance of what we have in common with the world, this form fails to grasp the importance of what is distinctive about the Christian worldview — namely, that the gospel reframes all things, not just religious things.

“The integration of faith and work is the opposite of dualism. We should be willing to be very engaged with the cultural and vocational worlds of non-Christians. Our thick view of sin will remind us that even explicitly Christian work and culture will always have some idolatrous discourse within it. Our thick view of common grace will remind us that even explicitly non-Christian work and culture will always have some witness to God’s truth in it. Because Christians are never as good as their right beliefs should make them, we will adopt a stance of critical enjoyment of human culture and its expressions in every field of work. We will learn to recognize the half-truths and resist the idols; and we will learn to recognize and celebrate the glimpses of justice, wisdom, truth, and beauty we find around us in all aspects of life. Ultimately, a grasp of the gospel and of biblical teaching on cultural engagement should lead Christians to be the most appreciative of the hand of God behind the work of our colleagues and neighbors.”

"Every Good Endeavor"

“Christians’ disengagement from popular culture usually carries over into dualism at work. “Dualism” is a term used to describe a separating wall between the sacred and the secular. it is a direct result of a thin view of sin, common grace, and God’s providential purposes.

“Dualism leads some to think that if their work is to please Christ, it must be done overtly in his name. They feel they have to write and perform art that explicitly mentions Jesus, or teach religious subjects in a Christian school; or that they must work in an organization in which all people are professing Christians. Or they must let everyone know that they lead Bible studies in the office in the morning before work hours. This kind of dualism comes both from a failure to see the panoramic scope of common grace and the subtle depths of human sin.  People with this view cannot see that work done by non-Christians always contains some degree of God’s common grace as well as the distortions of sin. And they cannot see that work done by Christians, even if it overtly names the name of Jesus, is also significantly distorted by sin.

“The opposite dualistic approach, however, is even more prevalent — and based on our experience, even more difficult to dismantle. In this approach, Christians think of themselves as Christians only within church activity. Their Christian life is what they do on Sundays and weeknights, when they engage in spiritual activities The rest of the week they have no ability to think circumspectly about the underlying values they are consuming and living out. In their life and work “out in the world,” they uncritically accept and reenact all of their culture’s underlying values and idolatries of self, surface appearances, technique, personal freedom, materialism, and other features of expressive individualism. While the first form of dualism fails to grasp the importance of what we have in common with the world, this form fails to grasp the importance of what is distinctive about the Christian worldview — namely, that the gospel reframes all things, not just religious things.

“The integration of faith and work is the opposite of dualism. We should be willing to be very engaged with the cultural and vocational worlds of non-Christians. Our thick view of sin will remind us that even explicitly Christian work and culture will always have some idolatrous discourse within it. Our thick view of common grace will remind us that even explicitly non-Christian work and culture will always have some witness to God’s truth in it. Because Christians are never as good as their right beliefs should make them, we will adopt a stance of critical enjoyment of human culture and its expressions in every field of work. We will learn to recognize the half-truths and resist the idols; and we will learn to recognize and celebrate the glimpses of justice, wisdom, truth, and beauty we find around us in all aspects of life. Ultimately, a grasp of the gospel and of biblical teaching on cultural engagement should lead Christians to be the most appreciative of the hand of God behind the work of our colleagues and neighbors.”

Surprised by Hope: Rethinking Heaven, the Resurrection and the Mission of the Church

NT WrightWhat would the resurrection have to do with the mission of the church? NT Wright makes a plea for us to connect the two.  Our modern assumptions about life after death seem to disconnect the reality of life in this world and the next, but the Bible does just the opposite.

“It has often been observed that the robust Jewish and Christian doctrine of the resurrection, as part of God’s new creation, gives more value, not less, to the present world and to our present bodies. What these doctrines give.. is a sense of continuity as well as discontinuity, between the present world and the future, whatever it shall be, with the result that the present matters tremendously.”

As a boy growing up in a major Christian tradition, I came to believe that what really matters is what is going on “in my soul.” My body seemed to be less important, less spiritual.  Wright shows us that this is so far from the truth. “In other words, the idea that every human possesses an immortal soul, which is the ‘real’ part of him, finds little support in the Bible,” he says.

The Scripture is clear that at the end of the present age there will be a resurrection of the bodies of the dead; see for example the book of Daniel where we read, “And many from those sleeping ⌊in the dusty ground⌋ will awake, some to ⌊everlasting life⌋ and some to disgrace and ⌊everlasting contempt⌋.” Daniel 12:2.

“Paul speaks of the future resurrection as a major motive for treating our bodies properly in the present time (1 Cor 6:14), and as the reason for not sitting back and waiting for it all to happen but for working hard in the present..”

Remember Jesus has risen from the dead, having conquered sin and death, and he came forth with a physical body, not unlike the body he had before death. Remember he still had (and has) the scars of the nails in his hands. And today he is still has a physical body, a kind of early “fruit” of what a the renewed earth will be like when he returns!

“It was people who believed robustly in the resurrection, not the people who compromised and went in for a mere spiritualized survival, who stood up against Caesar in the first centuries of the Christian era. A piety that sees death as the moment of ‘going home at last,’ the time when we are ‘called to God’s eternal peace,’ has no quarrel with power-mongers who want to carve up the word to suit their own ends. Resurrection, by contrast, has always gone with a strong view of God’s justice and of God as the good creator. Those twin beliefs give rise not to a meek acquiescence to injustice in the world but to a robust determination to oppose it. English evangelicals gave up believing in the urgent imperative to improve society (such as we find with Wilberforce in the late eighteenth century and early nineteenth century) about the same time that they gave up believing robustly in resurrection and settled for a disembodied heaven instead.”

It is not just our souls that are important but our bodies, both on earth now, before death, in the new heaven and new earth to come.  At Easter Jesus surprised the whole world by coming forward from that future into the present with His resurrection body. Let us trust and honor Him, who provides the only bridge between these worlds; this means obeying Him and being light and salt in this world around us!